Clinical efficacy of pratisaraneeya kshara karma on dusta vrana (chronic ulcer)

Dusta vrana (Chronic ulcer)  is  one  of  the  conditions  which  have  prolonged  healing  time depending  on  existing  primary  cause.  Many clinical researches are carried out in the management of dusta vrana.  Kshara (caustics alkali) is deemed among the instruments because of specific properties like chedana (exicition), bhedana (incision), lekhana (scraping), and ability to alleviate vitiated three doshas. Acharya Sushruta, explains kshara karma as one of the sixty procedures for management of ulcer and it can also be indicated in dusta vrana. In  clinical  practice, it  was  noted  that  even  after  prakshalana (spraying), dressing  and  other measures of vranaropana (healing measures), vrana remained without healing. Understanding its importance, initiations have been tried to establish the efficacy of pratisaraneeya kshara in dusta vrana through a clinical trial. In this study, five patients have been selected from the OPD/IPD of Shalyatantra Department of Sri Kalabyraweshwara swamy Ayurvedic Medical College Hospital and Research Center, Bangalore, between January 2014 to June 2014, After the approval from the institutional ethical committee.  In this study a clinical trial was made on dusta vrana by the application of Apamarga kshara (caustics prepared from Achyranthes aspera) to initiate the process of healing. Under aseptic precautions, pratisaraneeya kshara was applied on the dusta vrana, Then observed for 100 matra kala (around 35 sec to 1 min)   followed by washing of vrana with fresh lemon fruit juice. Following this, dressing was done with yastimadhu gritha. It was observed that the areas of hypertrophied granulation tissue become soft and the unwanted tissues were separated from their base which was easily removable. Discharges from the wound reduced remarkably, initiating the growth of healthy granulation tissue. The results obtained were found very encouraging.